Herb Formulas Notebook

Si Ni Jia Ren Shen Tang

Frigid Extremities plus Ginseng Decoction

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Source: Discussion of Cold Damage (c. 220)
Author: Zhang Ji / Zhong-Jing

Category: Formulas that Warm Interior Cold

Pattern: Cold Inversion Shaoyin disorder injuring the Yin and Blood and harming the Yuan Qi.

Key Symptoms: Extremely cold extremities, aversion to cold, lethargy with a constant desire to sleep, breathlessness
Secondary Symptoms: Lying down in foetal position, vomiting, painful and cold abdomen, increased urination, absence of thirst

Tongue: Pale, little or thin white coating
Pulse: Thin, submerged, faint
Abdomen: Weak muscle tone, skin folds can be easily lifted up, splashing sounds

Ren Shen 3-9g
Fu Zi 5-15g
Gan Jiang 5-9g
Zhi Gan Cao 6g

In the UK Fu Zi has to be replaced although no useful substitute can be made in this context making the inclusion of this formula for reference only. For a less severe presentation using the maximum amount of Gan Jiang to warm the middle and adding Gui Zhi to warm the extremities may be possible but this would not be a Shaoyin Cold Inversion pattern.

Preparation: Decoction.

Actions: Rescues devastated Yang, warms the middle Jiao, nourishes the Yin and Qi.

Contraindications: True heat and false cold (Si ni san presentations)

This formula is designed for a Si Ni Tang presentation when the diarrhoea ceases but the extremities remain cold. It is also often used for Si Ni Tang patterns with breathlessness.

Research Links:
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.